Near-infrared diffuse optical monitoring of cerebral blood flow and oxygenation for the prediction of vasovagal syncope
Near-infrared diffuse optical monitoring of cerebral blood flow and oxygenation for the prediction of vasovagal syncope
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DOI：
10.1117/1.jbo.19.1.017001
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发表时间：
2014-01-01
影响因子：
3.5
通讯作者：
Yu, Guoqiang
中科院分区：
文献类型：
--
作者：
Cheng, Ran;Shang, Yu;Yu, Guoqiang
血管迷走性晕厥（VVS）时，动脉血压和脑血流动力学显著下降。在VVS期间连续和同时监测这些生理变量是罕见的，但对于确定哪个变量是预测VVS的最敏感参数至关重要。本研究使用了一种新型的定制设计的弥散相关光谱流量血氧计和手指体积描记器，以同时监测脑血流量（rCBF）、脑氧合（即，氧合/脱氧/总血红蛋白浓度：r[HbO（2）]/r[Hb]/rTHC）和70 °头高位倾斜（HUT）时的平均动脉压（rMAP）。6例受试者在HUT期间出现晕厥前期。在晕厥前组中观察到HUT期间的两阶段生理反应：测量变量的缓慢和微小变化（即，I期），随后rMAP、rCBF、r[HbO（2）]和rTHC（即，阶段II）。与其他生理变量相比，rCBF在两个阶段之间最早达到其断点，并且在晕厥前期下降最大（76 +/- 8%）。我们的研究结果表明，rCBF具有最好的敏感性VVS的评估。最重要的是，类似于50%rCBF下降的阈值完全将受试者与无晕厥先兆的受试者分开，表明其预测VVS的潜力。(C)2014年光学仪器工程师学会（SPIE）
Significant drops in arterial blood pressure and cerebral hemodynamics have been previously observed during vasovagal syncope (VVS). Continuous and simultaneous monitoring of these physiological variables during VVS is rare, but critical for determining which variable is the most sensitive parameter to predict VVS. The present study used a novel custom-designed diffuse correlation spectroscopy flow-oximeter and a finger plethysmograph to simultaneously monitor relative changes of cerebral blood flow (rCBF), cerebral oxygenation (i.e., oxygenated/deoxygenated/total hemoglobin concentration: r[HbO(2)]/r[Hb]/rTHC), and mean arterial pressure (rMAP) during 70 deg head-up tilt (HUT) in 14 healthy adults. Six subjects developed presyncope during HUT. Two-stage physiological responses during HUT were observed in the presyncopal group: slow and small changes in measured variables (i.e., Stage I), followed by rapid and dramatic decreases in rMAP, rCBF, r[HbO(2)], and rTHC (i.e., Stage II). Compared to other physiological variables, rCBF reached its breakpoint between the two stages earliest and had the largest decrease (76 +/- 8%) during presyncope. Our results suggest that rCBF has the best sensitivity for the assessment of VVS. Most importantly, a threshold of similar to 50% rCBF decline completely separated the subjects from those without presyncope, suggesting its potential for predicting VVS. (C) 2014 Society of Photo-Optical Instrumentation Engineers (SPIE)